How Doctors Can Approach End-of-Life Conversations

Posted on 09/28/2015

Wall Street Journal — In 2016, after years of controversy, Medicare plans to begin reimbursing doctors for having discussions with patients about what type of medical care they want and don’t want near the end of their lives.

Private insurers are likely to follow, some experts say, meaning voluntary end-of-life counseling could soon become a part of standard medical care.

For many in the medical community, it’s a much-needed change. Most researchers and physicians agree that too many people in the U.S. receive treatments they never would have wanted or that don’t align with their values as they near death. Indeed, although most people if given a choice would prefer to spend their final days at home, surrounded by loved ones, about 70% of people die in hospitals, nursing homes and long-term care facilities, according to the Centers for Disease Control and Prevention.

“It’s better to work through end-of-life issues while people are still alive so that [family members] can look back and feel that they did it right,” says Ira Byock, a palliative-care expert who leads the Providence Institute for Human Caring in Torrance, Calif.